Combination of MRI and mammography screenings detects early-stage breast cancer

September 11, 2015

The study established the standard of care regarding when to give tamoxifen in relation to chemotherapy. The chemotherapy group was divided into women who began taking tamoxifen during chemotherapy and those who waited until they were done with chemotherapy before taking tamoxifen. Women who took tamoxifen after chemotherapy had better disease-free survival and overall survival.Over the past several years, Albain and colleagues have presented ongoing data from this study, and their findings already have influenced how doctors around the world are treating breast cancer.

In the second study, published in Lancet Oncology, Albain and colleagues did a retrospective analysis to determine whether a 21-gene test can predict which women would benefit from chemotherapy.

The test, Oncotype DX?, is performed by Genomic Health Inc. The test examines 21 genes from a tumor sample to determine how active they are. A score is reported, which is then correlated with benefit to chemotherapy. The analysis found there appeared to be no benefit to women who had a low score on the gene test, while those with higher scores did benefit.

More than 100,000 breast cancer patients have undergone the test since it became commercially available in 2004 for patients with estrogen-receptor positive breast cancer that has not spread to the lymph nodes. The new study indicates the test also could be useful in predicting whether chemotherapy -- the current standard -- could be avoided in a subgroup of patients whose cancer has spread to lymph nodes, Albain said.

"This study, along with other studies involving different gene tests, suggests that certain biologic subtypes of breast cancer may inherently be either susceptible to chemotherapy or resistant to chemotherapy," Albain said. "Prospective studies with larger sample sizes are needed to determine who will optimally benefit from chemotherapy."

Source: Lancet and Lancet Oncology